ESIS ProClaim Senior Representative, A&H

Reposted 2 Days Ago
Be an Early Applicant
Overland Park, KS, USA
In-Office
78K-112K Annually
Senior level
Insurance
The Role
Manage travel, hospital indemnity, accident, and AD&D claims by investigating losses, reviewing medical and travel documentation, interpreting policy language, establishing reserves, preparing coverage letters/reports, settling claims, and delivering customer service while escalating complex issues and supporting quality and process improvements.
Summary Generated by Built In

The Accident & Health and Travel Adjuster is responsible for the day-to-day management of an inventory of travel, hospital indemnity, hospital accident, and accidental death and dismemberment claims. This role reviews medical and travel documentation, investigates losses, interprets policy language to determine coverage and payment, evaluates and updates reserves, prepares coverage letters and reports, and delivers high-quality customer service.

This position reports to the Team Leader. The selected candidate should demonstrate initiative, strong prioritization skills, the ability to manage multiple priorities, adaptability, and the ability to meet claim handling requirements and industry best practices in a fast-paced, changing environment.

This position requires in-office work a minimum of three days per week.

Position Responsibilities

Duties include, but are not limited to:

  • Reviews claim and policy information to support investigations and determine the company’s obligation to the insured, based on the line of business.
  • Contacts and interviews insureds, claimants, witnesses, physicians, attorneys, police officers, and other relevant parties to obtain information needed to evaluate claims.
  • Assesses travel-related losses, including trip cancellation, trip interruption, medical emergencies, baggage loss, travel delays, and other covered events.
  • Evaluates facts gathered through investigation to determine liability and the company’s obligation under the policy contract.
  • Prepares reports related to investigations, settlements, claim denials, and evaluations of involved parties.
  • Maintains detailed claim notes, accurate documentation, and complete file records.
  • Responds to customer inquiries professionally and provides clear status updates.
  • Ensures timely claim handling in accordance with service standards and regulatory requirements.
  • Establishes reserves within authority limits and recommends reserve changes to the Team Leader.
  • Reviews claim progress with the Team Leader and discusses issues and recommended actions.
  • Identifies unusual or potentially adverse exposures and escalates them to the Team Leader as needed.
  • Supports the Team Leader in developing improved claims handling methods and processes.
  • Settles claims promptly and equitably.
  • Obtains releases, proofs of loss, or compensation agreements and issues claim payments.
  • Identifies potential fraud indicators and escalates suspicious claims when appropriate.
  • Communicates claim outcomes to claimants, insureds, customers, or attorneys.
  • Supports quality, compliance, and continuous improvement efforts in claims handling.
Qualifications
  • Strong time management skills and the ability to work independently
  • Proficiency with Microsoft Office applications, including Excel, Word, and PowerPoint
  • Strong written communication skills, with the ability to document policy interpretation clearly and accurately
  • Strong customer service skills
  • Experience using claims handling systems
  • Adjuster licensing preferred
  • Claims handling experience preferred
  • Ability to work collaboratively in a team environment and adapt to changing priorities and circumstances

An applicable resident or designated home state adjuster’s license is required for ESIS Field Claims Adjusters.  Adjusters that do not fulfill the license requirements will not meet ESIS’s employment requirements for handling claims. ESIS supports independent self-study time and will allow up to 4 months to pass the adjuster licensing exam.

ESIS, a Chubb company, provides claim and risk management services to a wide variety of commercial clients. ESIS’ innovative best-in-class approach to program design, integration, and achievement of results aligns with the needs and expectations of our clients’ unique risk management needs. With more than 70 years of experience, and offerings in both the U.S. and globally, ESIS provides one of the industry’s broadest selections of risk management solutions covering both pre- and post-loss services.

ESIS Specialty continually monitors, measures, and analyzes trends while working closely with clients to identify opportunities to positively impact their program costs. ESIS Specialty applies a balanced approach to claims handling and management and continually refines approach to be sure services are customized, complementary and complete.

The pay range for the role is $78,000 to $112,000. The specific offer will depend on an applicant’s skills and other factors. This role may also be eligible to participate in a discretionary annual incentive program.  Chubb offers a comprehensive benefits package, more details on which can be found on our careers website. The disclosed pay range estimate may be adjusted for the applicable geographic differential for the location in which the position is filled.

About Us
Chubb is a world leader in insurance. With operations in 54 countries, Chubb provides commercial and personal property and casualty insurance, personal accident and supplemental health insurance, reinsurance, and life insurance to a diverse group of clients. The company is distinguished by its extensive product and service offerings, broad distribution capabilities, exceptional financial strength, underwriting excellence, superior claims handling expertise and local operations globally.

At Chubb, we are committed to equal employment opportunity and compliance with all laws and regulations pertaining to it. Our policy is to provide employment, training, compensation, promotion, and other conditions or opportunities of employment, without regard to race, color, religious creed, sex, gender, gender identity, gender expression, sexual orientation, marital status, national origin, ancestry, mental and physical disability, medical condition, genetic information, military and veteran status, age, and pregnancy or any other characteristic protected by law. Performance and qualifications are the only basis upon which we hire, assign, promote, compensate, develop and retain employees. Chubb prohibits all unlawful discrimination, harassment and retaliation against any individual who reports discrimination or harassment.

Skills Required

  • Applicable resident or designated home state adjuster license
  • Proficiency with Microsoft Office (Excel, Word, PowerPoint)
  • Experience using claims handling systems (e.g., ProClaim)
  • Strong written communication and documentation skills
  • Strong time management and ability to work independently
  • Ability to work in-office a minimum of three days per week
  • Strong customer service skills and ability to collaborate in a team
  • Claims handling experience
Am I A Good Fit?
beta
Get Personalized Job Insights.
Our AI-powered fit analysis compares your resume with a job listing so you know if your skills & experience align.

The Company
HQ: Zürich
27,791 Employees

What We Do

Chubb is the world’s largest publicly traded property and casualty insurance company. With operations in 54 countries and territories, Chubb provides commercial and personal property and casualty insurance, personal accident and supplemental health insurance, reinsurance and life insurance to a diverse group of clients. As an underwriting company, we assess, assume and manage risk with insight and discipline. We service and pay our claims fairly and promptly. The company is also defined by its extensive product and service offerings, broad distribution capabilities, exceptional financial strength and local operations globally. Parent company Chubb Limited is listed on the New York Stock Exchange (NYSE: CB) and is a component of the S&P 500 index. Chubb maintains executive offices in Zurich, New York, London, Paris and other locations, and employs 31,000 people worldwide. Additional information can be found at: chubb.com.

Similar Jobs

Cox Enterprises Logo Cox Enterprises

Account Manager

Artificial Intelligence • Automotive • Greentech • Information Technology • Machine Learning • Software • Cybersecurity
Hybrid
Wichita, KS, USA
50000 Employees
68K-128K Annually

CrowdStrike Logo CrowdStrike

Staff Engineer

Cloud • Computer Vision • Information Technology • Sales • Security • Cybersecurity
Remote or Hybrid
USA
11000 Employees
195K-290K Annually

Optum Logo Optum

Home Infusion Registered Nurse

Artificial Intelligence • Big Data • Healthtech • Information Technology • Machine Learning • Software • Analytics
In-Office
Lawrence, KS, USA
160000 Employees
29-52 Hourly
Remote or Hybrid
US
15100 Employees
1K-1K Hourly

Similar Companies Hiring

Globe Life Thumbnail
Insurance • Financial Services
McKinney, TX
3000 Employees
MassMutual India Thumbnail
Big Data • Fintech • Information Technology • Insurance • Financial Services
Hyderabad, Telangana
Granted Thumbnail
Artificial Intelligence • Healthtech • Insurance • Mobile • Financial Services
New York, New York
23 Employees

Sign up now Access later

Create Free Account

Please log in or sign up to report this job.

Create Free Account